An Antimony key to unlock
medieval medicineby Peter Morrell
It is a pity that neither this book review in BMJ [1]
nor the one that appeared in The Lancet [2], clearly reveals the true
nature of this exciting little book. Its small size [<100 pages]
fails to reveal how packed it is with useful information about Antimony,
and its chemical and therapeutic properties down the ages, or the
remarkable knowledge the book displays of medieval medicine in general,
alchemy and the metaphysical connotations of this unusual metal. It
successfully opens up to the reader, the entire world of medieval
medicine, to such an incredible degree, that one enters the very
medieval mind itself, even more intimately than in the book by Getz [3],
also reviewed in BMJ recently – which is densely detail-laden, but
pedestrian by comparison. However, neither book review [1, 2] brings out
clearly and surely enough the real reason why Antimony was so
sought-after and relied-upon by medical practitioners from c.900-1900.“…in the world in which the ancestors of
modern medicine practised…religion and medicine can scarcely be
teased apart…” [3]“Disease is a supernatural phenomenon
governed by a hierarchy of vital powers…disharmony in these vital
powers can cause illness. Thus, ancestral spirits can make a person
ill. Ingredients obtained from animals, plants, and other objects
can restore the decreased power in a sick person and therefore have
medicinal properties.” [4]The essential point about Antimony is that it was a
powerful purgative and emetic combined. Because Christ was the saver
of souls and a spiritual cleanser that swept through ones
life removing all the bad, this cimed through analogy with the Greek
concept of humours and that we are ill because we are sinful
and therefore can be cured by the removal of excess putrid matter
within our mind or body. This concept resonates very deeply with
certain medical practices that persisted for far longer than can be
explained by our modern, rational views – e.g. antimony.“If the cure was infinitely worse than the
disease, the prospect of a treatment capable of eliminating all
corruption from the body, was surely irresistible. In the last
resort, the triumph of hope over experience may explain why antimony
enjoyed such an enduring popularity.” [1]Those drugs that had a purging effect were extolled
as being especially virtuous and efficacious – as powerful healing
agents sent to man by God. Such a sentiment seemed so obvious to the
medieval mind.“…in the seventeenth century…the accent
of therapeutics lay on expelling toxic substances from the body – by
purging, sweating, vomiting, and the much favoured surgical
technique of bloodletting…” [5]“…above all, sickness was regarded as the
finger of Providence. God used illness for a multitude of higher
purposes…as a punishment…” [6]Purgatives, emetics, enemas and bloodletting were all
highly prized means to purify the organism and to wash away putrid
matter that was conceived as a tangible cause of ill-health. Although
sin and wickedness were regarded as the ultimate and intangible or
spiritual causes of disease, the putrid tangibles were conceived as
their physical counterparts, which must therefore be forcibly expelled
from the patient in order to cure disease. To purge was to cleanse and
thus to heal this was the simple logic behind the practice. The
physical process mimicked the mental purging of the soul required to
stand closer to Christ. Apart from this, fasting and purging works – it
has a stilling and calming effect on active disease and normalises body
function.Just as fasting, and painful self-immolation and
flagellation were encouraged in religious purification, bringing one
closer to God, such spiritual purification was accompanied for many
centuries by a medical predilection to internally cleanse the patient,
using bloodletting, emetics and purgatives to drive out the poisons. A
parallel was drawn between the alleged alchemical properties of Antimony
and its assumed therapeutic action:“Antimony for medical use has a history
stretching back to ancient times. But the use of such a potentially
toxic purgative…was revered by alchemists because of its uncanny
power to purify gold.” [1]
In this worldview, the patient is in the corrupted
sinful state of man – the alchemical dross of Lead; the cure is some
form of divine assistance through an agent or elixir of a religious
nature, and the perfected or healed man is akin to absorption into
Christ or made-whole [healed], redeemed and thus a spiritualised
person – the alchemical Gold. Such treatment methods were accepted, and
endured, for so long precisely because they were believed to be sound
a religious belief grounded in the law of analogy. That is why
Antimony held such a magical hold over medicine for a millennium.
“…to the early Christians food was not a
particularly religious issue, until the late third century, when
fasting came to be seen as a sign of holiness and as an effective
means of subjugating the bodily temptations of gluttony and sexual
desire….the pleasure of good food was seasoned with guilt and fear
of damnation by Christian writers of the fourth century.” [7]
Adopting a profoundly organic view of the organism,
medievalists did not believe that poisons act upon the chemical or
material level, as we do today, but chiefly on a vital or dynamic level;
that poisons act in this way because each carries with it, an especially
strong harmful spirit, which comprises the true essence of its
medicinal nature. Thus, any chemical effect, as we today would call it,
was viewed as a harmful strong spirit within the poison, carried by the
drug and impacting purely as a dynamic effect, upon the bodys
spirit-like vital force, which controls the life processes, and
not upon what we today regard as the chemical machine. They did
not, in any case, view the organism in the chemical terms we do today,
so how could they view the action of poisons as we do? In broad terms,
the medieval notion does still have a phenomenological truth to it.
Poisons, diseases and drugs, apprehended not in
material terms, but as aspects of the functioning of the dynamis or
vital force, depict the medieval notion of vitalism as characterised by
Paracelsus and Stahl. This Neo-Platonist view held that behind all
physical, observable phenomena lay a realm of spiritual causes. To this
mentality, forms are merely the illusory and imperfect projections of a
deeper, more profound spiritual realm that underpins and drives physical
reality. Thus, any physical or chemical event was not caused by the
material forms themselves, but by unseen immaterial energies acting as
the true causes behind the events themselves. If physical events were
the puppets, then the puppeteers, who pull the strings, exist in
another, invisible, spiritual realm.
This viewpoint arose partly through transferring the
apparent and long-accepted vitality of living things [spirit,
soul] onto physical forms. It also derives from the general pantheism
that held that everything – all inanimate forms – are secretly alive in
some manner each imbued with a unique spirit. The notion of the
vital force thus reflects a general perception of God behind his
creation and mini-Gods behind each individually created thing, each with
its own unique properties – manifestations of the mini-God or internal
essence. It all made perfect sense at the time.
There are many examples of the total lack of
understanding within modern medicine of medieval medicine. One good
example concerns the use of Antimony.
“…physicians who prescribed antimony…were
just as imbued with tenets of faith, superstition, and mysticism,
complemented by prejudgements, lack of resistance to fad and fashion,
and absence of any inclination to apply scientific method, as were the
pretenders to medical knowledge….incapability for trenchant critical
thought…[and] lose their intellectual moorings in favour of flights
of fancy…” [2]
This evaluation places an unfairly modern spin
on medieval medical conception – condemning it all as magic, entirely
from the modern perspective, informed with a chemistry the medievalists
were largely oblivious of. This completely misses the basis of the
medieval worldview. They cannot be blamed for what they did not know.
They could not do things any differently. They did have reason and
critical thought, but it was hidebound by a certain approach –
just as science is today.
“Metallic compounds began to be introduced
into medicine on account of their violent effects on the body…”
[8]
The fascination and obsessive manner of their
medicinal use entirely shadowed their toxicity. Antimony in moderate
dose was a powerful purgative, able to cleanse the body of noxious
impurities – which is what Christian faith demanded of a drug, the
noxious matter being seen as a physical analogue of the spiritual root
cause of all disease – sin.
Medievalists tended to be dismissive of mechanical
explanations, measurement, quantitative methods, etc, precisely
because their eyes were mostly focused upon the internal, essential
and nebulous realm of of causes that lay behind the
material processes, and not the visible processes per se.
In the seventeenth century, as the medieval view
disintegrated, and began to be replaced by scientific notions, so
advances in science engendered new speculation, as medievalists
struggled – in vain – to incorporate the new ideas into the familiar
fabric of medieval conceptions. The two could not be successfully
integrated, and as science took off, so vitalism was left behind as a
medical anachronism.
Although some reference is made in this text by
Professor McCallum to the homeopathic uses of Antimony, it is worth
noting that it has mainly been used in homeopathy as a specific for
Impetigo and often with great success.
Sources
[1] Rawcliffe, Carole,
Antimony in Medical History by R Ian McCallum, Pentland Press, book
review, BMJ 2000; 320: 879 [25 March]
[2] Ackerman, A B,
2000, Antimony as a symbol in medicine – Book Review of Antimony in
Medical History by R Ian McCallum, The Lancet, 29 April 2000
[3] Lawrence,
Christopher, Medicine in the English Middle Ages by Faye Getz, book
review, BMJ 1999; 318: 880 [27 March]
[4] Kale, Rajendra,
Education and Debate, South African Health: Traditional healers in South
Africa: a parallel health care system, BMJ 1995; 310: 1182-85 (6 May)
[5] Porter, Roy, 1987,
Disease, Medicine and Society in England 1550-1860, Macmillan, London,
14
[6] ibid., 27
[7] Van der Eijk,
Philip, 1999, From Feasting to Fasting – The Evolution of a Sin by
Veronika E Grimm, Book Review, Soc. Hist. Med. 12.1, April 1999,159-60
[8] Bernal, J D, 1969,
Science in History, 3 vols., Penguin, London, 398